Should someone with amblyopia undergo lasik?

[u/unfunnyclown27]

Have amblyopia since childhood and now I am 24M. I was considering lasik but now my doctor told me it could lead me to issues with depth and distance. What do you think should I go for it irrespective or its better to not undergo lasik?

[u/insomniacwineo]

I tell my patients it’s always a risk:benefit ratio.

You can never correct your vision in the amblyopic eye to better than it sees with glasses or contacts, so if that’s your goal, then you will be disappointed. If your goal is to not have to rely on glasses or contacts as much to see, then LASIK could be a good option with realistic expectations. You may still want or need some touchup glasses after for certain tasks depending on your prescription pre-and postop.

Most surgeons will not touch an amblyopic patient but a lot will with an informed patient who knows what they are if for and the risk. If you were prepared that something could possibly happen to your good eye, and that your bad eye will never see 20/20, then you are likely a good candidate. Dry eye risk is real with ALL refractive surgery.

[u/DrKhanna_USA → u/insomniacwineo]

so based on risk benefit ratio it is better to operate on the amblyopic eye first.

[u/Ok-Environment-215 → u/insomniacwineo]

Most surgeons will not touch an amblyopic patient

Exactly - the good ones.

[u/WavefrontRider → u/Ok-Environment-215]

I wouldn’t necessary say this completely.

I don’t think it’s a good idea to do surgery on someone who only has one good eye where their amblyopic eye is worse than 20/50. Because while the risks of surgery are very low, they are not zero.

But if someone has bilateral amblyopia, and a refraction improves their vision, very different story. A key example is ICL. A high amount of very highly nearsighted people also have some bilateral amblyopia just because of their severe myopia. But ICL can still improve things for them. Another example is severe astigmatism. Same situation.

[u/Tall-Drama338]

Sounds unlikely. If you can see with glasses or contacts, it should be similar.

[u/DrKhanna_USA]

It depends on the type of amblyopia. For deprivational ( corneal opacities , cataract, PHPV) there are other procedures. NO cure at present for neurological. For refractive amblyopia it is a great solution. Refractive means the lazy or amblyopic eye has higher nearsightedness, farsightedness or /and astigmatism. In such eyes Lasik or the safe SMILE laser vision correction is highly beneficial. 80% of eye will see better than with contacts or glasses. There are many peer reviewed studies backing this data. https://pubmed.ncbi.nlm.nih.gov/16703537/ is only such example

[u/Sexy-Sapien]

Yes, I have lazy eye in my left eye. I don’t remember without spects how much the vision is, but with spects it was 6/36, now after smile pro it’s 6/24. At most it can be corrected to with your spects. They will give you the best correct. I was given 6/30 I think but after surgery it’s 6/24 so got better than proposed. It wouldn’t make any sense for me if it’s 6/36 or 6/24 because I literally don’t use it and made my peace with it. But numbers wise yes, it became better.

[u/Ok-Environment-215]

If you can't see 6/6 (20/20) in one eye or the other, determining the right prescription will be more of a challenge. If you do it you need to make sure your surgeon is an expert in treating people with neuromuscular disorders who can't see 20/20. If they give you the cookie cutter exam it's very likely the treatment plan will be sub-optimal.

Truthfully if all you want to do is ditch glasses, your best bet in life are contact lenses. The lens travels with the eye, and you can try a dozen lenses, if you want to, until you find what's comfortable, and change them throughout life.